Mass administrations of antimalarial drugs.

Administration of antimalarial drugs to whole populations has been used as a malaria-control measure for more than 70 years. Drugs have been administered either directly as a full therapeutic course of treatment or indirectly through the fortification of salt. Mass drug administrations (MDAs) were generally unsuccessful in interrupting transmission but, in some cases, had a marked effect on parasite prevalence and on the incidence of clinical malaria. MDAs are likely to encourage the spread of drug-resistant parasites and so have only a limited role in malaria control. They could have a part to play in the management of epidemics and in the control of malaria in areas with a short transmission season. To reduce the risk of spreading drug resistance, MDAs should use more than one drug and, preferably include a drug, such as an artemisinin, which has a gametocidal effect

New tools for malaria control - using them wisely.

The incidence of malaria in sub-Saharan Africa is falling and in many countries on the continent the pattern of malaria infection within the country is becoming more heterogeneous. National malaria control programmes need to take this into account and the 'one size fits all' approach to malaria control may no longer be appropriate, with individual approaches being needed in different parts of a country. This applies particularly to decisions on the introduction of new control tools. Recent experience with Seasonal Malaria Chemoprevention and with the RTS,S/AS01 malaria vaccine provides examples of interventions which need to be deployed on a restricted rather than a national basis, taking account of differences in climate and the intensity of malaria infection between regions within a country. Designing, implementing and monitoring more complex national malaria control programmes will require staff skilled in many disciplines, and substantial funding will be needed to sustain these more complex control programmes, even though the burden of the disease is falling

Accelerating vaccine development and deployment: report of a Royal Society satellite meeting.

The Royal Society convened a meeting on the 17th and 18th November 2010 to review the current ways in which vaccines are developed and deployed, and to make recommendations as to how each of these processes might be accelerated. The meeting brought together academics, industry representatives, research sponsors, regulators, government advisors and representatives of international public health agencies from a broad geographical background. Discussions were held under Chatham House rules. High-throughput screening of new vaccine antigens and candidates was seen as a driving force for vaccine discovery. Multi-stakeholder, small-scale manufacturing facilities capable of rapid production of clinical grade vaccines are currently too few and need to be expanded. In both the human and veterinary areas, there is a need for tiered regulatory standards, differentially tailored for experimental and commercial vaccines, to allow accelerated vaccine efficacy testing. Improved cross-fertilization of knowledge between industry and academia, and between human and veterinary vaccine developers, could lead to more rapid application of promising approaches and technologies to new product development. Identification of best-practices and development of checklists for product development plans and implementation programmes were seen as low-cost opportunities to shorten the timeline for vaccine progression from the laboratory bench to the people who need it